Jean Jude Alexis, APRN
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Bronx, NY
NPI 1205415585 · NPPES record last updated Jul 6, 2024
Key facts
- NPI
- 1205415585
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 405853 (NY)
- Practice address
- 120 Benchley PL FRNT 2
Bronx, NY 10475-3402 - Phone
- (347) 843-7760
- Fax
- (347) 843-7780
- NPI assigned
- Apr 5, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in FL, NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210914000481 | FL | Practitioner - Nurse Practitioner | 8123424371 | |
| I20250515002427 | NY | Practitioner - Nurse Practitioner | 8123424371 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP11013685 | FL | MD | Nurse Practitioner |
| 405853 | NY | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rimisac Family Health NP PC | Current |
Accepting new patients | |
| Brookview Medical Associates, PLLC | Nurse Practitioner | Current |
Accepting new patients |
| Rimisac Family Health NP PC | Current |
Accepting new patients |
Locations
80 Orville Dr
Ste 100
Bohemia, NY 11716
Phone (516) 308-6610
120 Benchley Pl
Frnt 2
Bronx, NY 10475
Phone (347) 843-7760
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 405853 | NY | Yes |
| Nurse Practitioner | 363L00000X | ARNP11013685 | FL |
Addresses
Primary practice location
120 Benchley PL FRNT 2
Bronx, NY 10475-3402
Mailing address
6415 Lake Worth Rd Ste 207
Greenacres, FL 33463-2904
Phone (613) 288-4205
Other practice location 1
14036 170th St
Jamaica, NY 11434-4632
Phone (347) 843-7760
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| APRN11013685 | Other | FL | BOARD OF NURSING |
Other providers in Bronx, NY
- Alex Alexanian
- Yvonne Alexis-Cherenfant
- Aisha Alexis
- Barbara Alexis
- Dimitri Alexis
- Karenza Michelle Alexis
- Michelle G Alexis
- Willy Alexis
- Celia Alfalla
- Nancy Alfaro
All providers in Bronx, NY · Psychiatric/Mental Health Nurse Practitioner in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 6, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.